Abstract:
BACKGROUND:Few studies have examined the association of race and outcomes after coronary artery bypass graft (CABG) surgery while controlling for both patient and hospital effects. METHODS AND RESULTS:We retrospectively analyzed data on a cohort of 566,785 white and 24,354 black Medicare beneficiaries 65 years old and older undergoing CABG in 1091 US hospitals from 1997 to 2000. Mortality and repeat revascularization rates were examined after sequential adjustment for patient and hospital differences by use of generalized estimating equations. Unadjusted mortality was higher (P<0.001) in black than in white patients at 30 (6.4% versus 5.2%), 90 (8.3% versus 6.6%), and 365 days (13.5% versus 9.8%) after surgery. Black patients were more likely (P<0.001) to undergo CABG at hospitals with the highest mortality (56% versus 47%) and at hospitals in the lowest volume quintile (24% versus 20%). Adjusted only for patient characteristics, mortality was 8%, 11%, and 25% higher in black patients at 30, 90, and 365 days. After adjustment for hospital effects, 30 and 90 day mortality was similar but 17% higher in black patients at 365 days. Racial differences in mortality were greater in men than in women. On adjustment for patient and hospital effects, repeat revascularization rates were similar in black and white patients. CONCLUSIONS:Racial disparities in CABG outcomes are sensitive to the effects of sex and duration of postsurgical follow-up. The increasing disparity in outcomes as follow-up increased is consistent with the hypothesis that black patients have less access to secondary prevention and rehabilitation services after surgery.
journal_name
Circulationjournal_title
Circulationauthors
Konety SH,Vaughan Sarrazin MS,Rosenthal GEdoi
10.1161/01.CIR.0000157728.49918.9Fsubject
Has Abstractpub_date
2005-03-15 00:00:00pages
1210-6issue
10eissn
0009-7322issn
1524-4539pii
111/10/1210journal_volume
111pub_type
杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:Premedication with clopidogrel has reduced thrombotic complications after percutaneous coronary revascularization procedures. However, because of the enhanced and irreversible platelet inhibition by clopidogrel, patients requiring surgical revascularization have a higher risk of bleeding complications and tr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.571828
更新日期:2006-04-04 00:00:00
abstract:BACKGROUND:Recent studies have suggested that endogenous erythropoietin (Epo) plays an important role in the mobilization of bone marrow-derived endothelial progenitor cells (EPCs). However, it remains to be elucidated whether the Epo system exerts protective effects on pulmonary hypertension (PH), a fatal disorder enc...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.583732
更新日期:2006-03-21 00:00:00
abstract:BACKGROUND:Endothelial integrity is essential for maintaining vascular homeostasis, and endothelial denudation results in neointimal thickening. Balloon-expandable endovascular stents provide a luminal scaffolding within atherosclerotic arteries with minimal direct contact between balloon and endothelium. We wondered w...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.11.2909
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Recent studies of beta-adrenergic receptor (beta-AR) subtype signaling in in vitro preparations have raised doubts as to whether the cAMP/protein kinase A (PKA) signaling is activated in the same manner in response to beta2-AR versus beta1-AR stimulation. METHODS AND RESULTS:The present study compared, in t...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.18.2458
更新日期:1999-05-11 00:00:00
abstract:BACKGROUND:Tumor necrosis factor alpha (TNF-alpha) increases in patients with severe congestive heart failure (CHF) and cachexia. Two naturally occurring modulators of TNF-alpha activity have been identified in human serum. These two soluble proteins are the extracellular domains of the TNF receptors (sTNF-RI and sTNF-...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.6.1479
更新日期:1995-09-15 00:00:00
abstract:BACKGROUND:Platelet deposition and aggregation are central to the pathogenesis of ischemic complications of acute coronary syndromes (ACS). Pharmacodynamic effects of the platelet glycoprotein IIb/IIIa antagonist eptifibatide have been delineated in healthy subjects but not in patients with ACS. We assessed effects of ...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/hc2901.093500
更新日期:2001-07-24 00:00:00
abstract::To investigate whether iron is involved in the reperfusion syndrome by aggravating free radical injury, the hearts from iron-loaded and control rats were perfused under normoxic, anoxic, and reperfusion conditions. Normoxic perfusion revealed no change in coronary flow, contractility, or lactate dehydrogenase (LDH) re...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.78.2.442
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:For patients with acute dilated cardiomyopathy, definition of prognosis and of clinical features predictive of outcome is particularly important due to the availability of cardiac transplantation and other innovative treatment strategies. METHODS AND RESULTS:We reviewed our experience with 24 children under...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.90.3.1310
更新日期:1994-09-01 00:00:00
abstract::More accurate characterization of coronary artery lesions is needed for evaluation of short and long-term interventions in coronary disease. A method of segmental artery analysis has been developed to maximize the information obtained from coronary arteriograms. Coronary lesions are traced from two projected, perpendi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.55.2.329
更新日期:1977-02-01 00:00:00
abstract:BACKGROUND:Several authors have reported cases in which 201Tl scintigraphy demonstrated perfusion abnormality in the septum of patients with left bundle branch block (LBBB) and normal coronary arteriogram. The mechanism of this abnormality, however, remains to be clarified. METHODS AND RESULTS:To determine whether LBB...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.85.3.1125
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Coronary blood flow occurs mainly during the diastolic phase of each cardiac cycle and is mainly dependent on diastolic driving pressure, especially in the left anterior descending coronary artery (LAD). We hypothesized that calculation of the ratio of the diastolic driving pressure of a stenotic LAD to its ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.19.2365
更新日期:2000-11-07 00:00:00
abstract::The effect of stenosis of the left main and proximal anterior descending coronary arteries on anterior left ventricular wall dynamics was investigated in 70 patients with ischemic heart disease by the use of roentgen videometric analysis of left ventricular angiograms. In all patients with ischemic heart disease, mean...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.58.3.491
更新日期:1978-09-01 00:00:00
abstract::In rats, atrial natriuretic factor (ANF) reduces sympathetic nerve activity (SNA) reflexively by sensitizing cardiac mechanoreceptors with inhibitory vagal afferents. We performed three series of experiments in 26 normal young men to document whether ANF inhibits SNA in humans and if so, to determine potential mechani...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.81.6.1860
更新日期:1990-06-01 00:00:00
abstract::The relation between ventricular dysrhythmia during the first 20 hours after hospitalization for acute myocardial infarction and enzymatically estimated infarct size was studied prospectively. The duration of dyshythmia was measured by the total time during which the average premature ventricular depolarization (PVC) ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1976-03-01 00:00:00
abstract:BACKGROUND:Experimental studies suggest that arterial injury and inflammation lead to increased neointimal growth after stenting. Despite the increased use of coronary stents in humans, there are only limited pathological data on the morphological features of in-stent restenosis. METHODS AND RESULTS:Detailed histology...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000019071.72887.bd
更新日期:2002-06-25 00:00:00
abstract::The ameliorative effect of antiplatelet therapy on atherogenesis of vein grafts was assessed in autologous cephalic veins grafted into femoral arteries of 16 normolipemic and 11 hyperlipemic stump-tailed macaque monkeys. Before grafting, one half of each vein was distended at high pressure (700 mm Hg) and the other ha...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.66.2.338
更新日期:1982-08-01 00:00:00
abstract:BACKGROUND:The identification of sites of dominant activation frequency during atrial fibrillation (AF) in humans and the effect of ablation at these sites have not been reported. METHODS AND RESULTS:Thirty-two patients undergoing AF ablation (19 paroxysmal, 13 permanent) during ongoing arrhythmia were studied. Electr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.517011
更新日期:2005-08-09 00:00:00
abstract:BACKGROUND:Heart failure (HF) with preserved ejection fraction (HFpEF) is a heterogeneous syndrome. Phenotyping patients into pathophysiologically homogeneous groups may enable better targeting of treatment. Obesity is common in HFpEF and has many cardiovascular effects, suggesting that it may be a viable candidate for...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.116.026807
更新日期:2017-07-04 00:00:00
abstract:BACKGROUND:Pharmacological ventricular rate control is an acceptable atrial fibrillation (AF) therapy limited by systemic toxicity. We postulate that focal catheter-based drug delivery into the atrioventricular nodal (AVN) region may effectively control ventricular rate during AF without systemic toxicity. This study e...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.609420
更新日期:2006-05-23 00:00:00
abstract:BACKGROUND:We sought to separately examine the effects of either weight loss or diets varying in protein content and glycemic index without further changes in body weight on cardiovascular risk factors within the Diet, Obesity, and Genes study (DiOGenes). METHODS AND RESULTS:DiOGenes is a pan-European controlled dieta...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.111.033274
更新日期:2011-12-20 00:00:00
abstract:BACKGROUND:Hypercholesterolemic mice lacking factors required for activation of CD4+ T cells are characterized by reduced development of atherosclerosis. Consequently, it has been assumed that atherosclerosis involves loss of tolerance against modified self-antigens generated in response to hypercholesterolemia and tha...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.118.039288
更新日期:2019-05-28 00:00:00
abstract:BACKGROUND:Myocardial injury from ischemia can be aggravated by reperfusion of the jeopardized area. The precise underlying mechanisms have not been clearly defined, but proinflammatory events, including complement activation, leukocyte adhesion, and infiltration and release of diverse mediators, probably play importan...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.95.3.701
更新日期:1997-02-04 00:00:00
abstract:BACKGROUND:Smooth muscle cell (SMC) migration and proliferation critically influence the clinical course of vascular disease. We tested the effect of the novel small leucine-rich repeat protein podocan on SMC migration and proliferation using a podocan-deficient mouse in combination with a model of arterial injury and ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.113.004634
更新日期:2013-11-26 00:00:00
abstract:BACKGROUND:It is well established that a depressed baroreflex sensitivity may adversely influence the prognosis in patients with chronic heart failure (CHF) and in those with previous myocardial infarction. METHODS AND RESULTS:We tested whether a slow breathing rate (6 breaths/min) could modify the baroreflex sensitiv...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/hc0202.103311
更新日期:2002-01-15 00:00:00
abstract::To estimate the extent of myocardial infarction after coronary artery reperfusion, serum levels of cardiac myosin light chain (LC) I and creatine kinase (CK) were determined serially in 49 patients with acute myocardial infarction. Intracoronary thrombolysis was successful in 25 patients (reperfusion group), and 24 pa...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.76.6.1251
更新日期:1987-12-01 00:00:00
abstract:BACKGROUND:Oxidized LDL (oxLDL) is thought to play a key role in the inflammatory response in the arterial vessel wall. METHODS AND RESULTS:In a prospective, nested, case-control study, the association between plasma oxLDL and risk of an acute coronary heart disease (CHD) event was investigated in men without prevalen...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.529297
更新日期:2005-08-02 00:00:00
abstract:BACKGROUND:The development of selective atrial antiarrhythmic agents is a current strategy for suppression of atrial fibrillation (AF). METHODS AND RESULTS:Whole-cell patch clamp techniques were used to evaluate inactivation of peak sodium channel current (I(Na)) in myocytes isolated from canine atria and ventricles. ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.704890
更新日期:2007-09-25 00:00:00
abstract::Of 22 children with congenital complete heart block (CCHB) available for study, 14 (63.6%) were born to 11 mothers with clinical or laboratory evidence of connective tissue disease, primarily lupus erythematosus (LE). Seven mothers had both clinical and laboratory evidence of disease while four had only positive labor...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.56.1.82
更新日期:1977-07-01 00:00:00
abstract:BACKGROUND:In patients with atrial fibrillation, intracardiac atrial defibrillation causes discomfort. An easily applicable, short-acting analgesic and anxiolytic drug would increase acceptability of this new treatment mode. METHODS AND RESULTS:In a double-blind, placebo-controlled manner, the effect of intranasal but...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.99.14.1837
更新日期:1999-04-13 00:00:00
abstract:BACKGROUND:Fetal tachycardia may cause hydrops fetalis and lead to fetal death. No unanimity of opinion exists regarding the optimum treatment. This study evaluates our experience with transplacental sotalol therapy to treat fetal tachycardias in terms of safety and efficacy. METHODS AND RESULTS:The charts of 21 patie...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/01.cir.101.23.2721
更新日期:2000-06-13 00:00:00